minot state university webinar with autism now april 12, 2011

8/7/2019 Minot State University Webinar with Autism NOW April 12, 2011

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Listen, Screen & Recognize the Red Flags for

Autism Spectrum Disorders



Presented Byy Lori Kalash, Ed. D. Project Director for Great Plains

Autism Spectrum Disorder Treatment Program

(GPAST) and Great Plains Interdisciplinary ClinicProject (GPIC)



What is autism?y Autism is defined using the Diagnostic and

Statistical Manual of Mental Disorders (DSM-IV-

TR) as a condition displaying delays orabnormalities in:

Social InteractionSocial Interaction

3



Pervasive Developmental Disordersy Autism

y Aspergers Syndrome

y PDD-NOSy Retts Syndrome

y Childhood Disintegrative Disorder



ACT EARLY KNOW THE SIGNS



http://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/TrackChildsDevMilestonesEng.pdf



SOCIAL DEVELOPMENT: 0-7 MONTHSTypical

y Develops Social Smile

y More expressive with face &

body y Imitates some movements

and expressions

y 4-7 monthsy Shows interest in watching

peoples facesy Smiles often while playing

with you

y Relate to parent with joy

y Interested in mirror images

y Red Flagsy Few facial expressions

y Doesnt cuddle

y Shows limited interest inwatching others



SOCIAL DEVELOPMENT: 6-12 MONTHSy Typical

y Stranger Anxiety

y Exchange back-and-forth facial expressions

y Joint Attention

y Social games peek-a-

boo, patty cake, othery Object permanence

y Red Flags

y Doesnt distinguish

caregiver from othersy Doesnt look where you

point

y Not interested in socialgames

y Flat emotion/affect withpeople



SOCIAL DEVELOPMENT: 12-24 MONTHSy Typical

y Use mother as securebase

y Separation distress

y Independence

y Knows people by pointing when named

y Simple pretendplay/imitation

y Red Flagsy No distress separating

from caregiver

y Strange attachment tohard objects (ratherthan stuffed animals)

y Doesnt seem to notice

you or others in theroom

y Seems to tune othersout and plays alone



SOCIAL DEVELOPMENT: 24 36 MONTHSy Typical

y Parallel Play: plays by peers

y Associative Play: someexchange: sharing, turn-taking

y Cooperative Play: play

together cooperate withcommon goal

y Imaginative Play (creative, pretending)

y Red Flagsy Solitary Play

y

Little interest in peersy No Showing, Giving of

toys

y May be more interestedin household objects

than toysy May not imitate others

through play



SOCIAL DEVELOPMENT: 3+ YEARSy Typical

y Creative Imaginative

Play y Recognizes emotions in

others

y Interest in others

y

Understand social rulesand routines

y Socially motivated

y Can take turns in games

y Red Flags

y Prefers to play alone

y Tunes others outy Difficulty reading body

language and emotions

y Lack of social

reciprocity (interest inothers,concern/recognition of others)



COMMUNICATION: 0-7 MONTHSTypical

y 3 Monthsy

Cooingy 4 Months

y Laughs

y Turns to voice

y

Follows and reacts tobright colors

y 5 Monthsy Razzing

y Red Flagsy Unusually Quiet

y

No attention to voices



COMMUNICATION: 6-12 MONTHSy Typicaly 6 Months

y Babblingy

Cries when unhappy y 8 Months

y Dada/mama nonspecifically

y 9 Monthsy Exchanges back-and-forth

soundsy Gesture games

y 10 Monthsy Understands noy Mama/dada specifically

y Red Flagsy No imitation of soundsy Only screechesy

No back and forth



COMMUNICATION: 12-24 MONTHSy Typicaly 12 Months

y One step command with a gesturey Turns toward person when name

is calledy 13 Months

y Immature jargoningy 15 Months

y One step command without agesture

y Uses and understands at least

three wordsy 18 Months

y Knows people by pointing whennamed

y Points to body partsy Mature jargoning

y Red Flagsy Any regression of skillsy Appears deaf y No babbling

y No Words by 15 Months



COMMUNICATION: 24 36 MONTHSy Typical

y 24 Months

y Puts two words togethery Uses and understands at

least 50 words

y Pronouns

inappropriately y Two step commands

y 34 Months

y States first name

y Red Flags

y Any regression

y

No compensation withgestures or sign



COMMUNICATION: 3+ YEARSy Typical

y 36 Monthsy Uses thoughts and actions

together in both speechand play

y Uses pronounsappropriately

y Older childreny Gradually understand

pragmatics (figures of speech, myth, symbolism,jokes)

y Red Flagsy May say words okay but

has a difficult time using

language functionally y Ex. Can say the ABCs,

numbers, or words to TV jingles but can't ask forthings he wants

y Laughs for no clear reason

y Uses words or phrases thatare inappropriate for thesituation

y Takes things literally



OTHER DEVELOPMENTy Fine/Gross Motor

y Cognitive skills

y Sensory y Does well with routine

y Red Flags

y Narrow or Restricted

interestsy Nonfunctional

adherence to routines orrituals

y Inflexible thinking

y Fascination with partsof objects(nonfunctional)



OTHER DEVELOPMENTy Fine/Gross Motor

y Cognitive skills

y Sensory

y Red Flags

y May have delays in

learning if they havepoor imitation skills

y Sensory difficultiesy Doesn't seem to have any

fear

y Doesn't seem to feel painy Oversensitive to noise,

texture

y Eating/Gastrointestinal



Screening & Early Interventiony Well-visits to childs pediatrician is the best time for

developmental screenings and for early identification

or concerns regarding autism. Without identificationthrough screening, a child may not receive the early &intensive interventions he or she needs.

y Early and appropriate intervention can be the key to

greater independence, increased participation in thewider community, and ultimately, a more productiveand fulfilling life as an adult.

y Identification is essential for intervention.http://www.firstsigns.org/screening/index.htmSee handout on Normal Developmental Milestones



A.L.A.R.My A utism is prevalent

y Approximately 1 in 110 according to ADDM network

study released in December 2009. (Autism andDevelopmental Disabilities Monitoring/Center forDisease Control)

y Developmental disorders have subtle signs and may beeasily missed.



A.L.A.R.My Listen to parents

y Early signs of autism are often present before 18 months

y

Parents usually DO have concerns that something iswrong

y Parents generally DO give accurate and quality information

y

When parents do not spontaneously raise concerns, askif they have any



A.L.A.R.My A ct early

y Make screening and surveillance an important part of

medical practice. AAP recommends routine screeningfor ASD in all children at 18 and 24 months.

y Know the subtle differences between typical andatypical development

y Learn to recognize red flags

y Use validated screening tools

y Early and appropriate intervention



M-CHAT/CASTy First level screeners (free for educational and clinical

purposes at firstsigns.org)

y

False positivesy Interview to clarify answers

y Screening recommended at 18 and 24 months for allchildren. (MCHAT)

y Screening advised at elementary level for all children(CAST)



A.L.A.R.My R efer

y to Early Intervention or school programs (Do not wait

for diagnosis)y To an autism specialist, or team of specialists,

immediately for definitive diagnosis

y To audiology to rule out a hearing impairment

y

To local community resources for help and family support.



A.L.A.R.My Monitor

y Other conditions know to be associated with autism

(seizures, GI, sleep, behavior)y Educate parents and provide them with up-to-date

information

y Advocate for families with other agencies

y

Watch for additional or late signs of autism and/or otherdevelopmental disorders



Basic Screening Guidelines

http://www.firstsigns.org/screening/guidelines.htmPractice parameter: Screening and diagnosis of

autism. Neurology 2000, 55: 468-79.



Q uestionsy [email protected]

minot state university webinar with autism now april 12, 2011

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